ICD-10 C14.8
Billable / Specific HCC v28: 11Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx
About ICD-10-CM C14.8
ICD-10-CM code C14.8 represents Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx. This is a billable/specific code in the Neoplasms chapter (block C14). The 2026 edition of ICD-10-CM C14.8 became effective on October 1, 2025.
Coding Tips for C14.8
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
C14.8 is a CMS-HCC v28 risk-adjustment code (category 11). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under C14.8. Per CMS ICD-10-CM Tabular 2026.
- Primary malignant neoplasm of two or more contiguous sites of lip, oral cavity and pharynx
Type 1 Excludes
Pure excludes, these codes can never be coded together with C14.8. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- 'book leaf' neoplasm [ventral surface of tongue and floor of mouth] (C06.89)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for C14.8
Local Coverage Determinations (LCDs) from CMS MACs that list C14.8 as a covered diagnosis.
Showing top 10 of 897 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing C14.8.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with C14.8
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 97130 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92608 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 97129 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92607 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 96110 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92524 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92508 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92597 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 92521 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
- 96105 CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders CMS LCD
Convert C14.8 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| C14.8 | 1498 | 10000 |
| C14.8 | 1499 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To C14.8
Other codes in section C00-C14 (Malignant neoplasms of lip, oral cavity and pharynx).
ICD-10 C14.8, Billing FAQ
Is ICD-10 code C14.8 billable? +
Yes, C14.8 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to C14.8? +
ICD-10 C14.8 includes: Primary malignant neoplasm of two or more contiguous sites of lip, oral cavity and pharynx.
What codes are Type 1 Excludes for C14.8? +
Type 1 Excludes (never code together with C14.8): 'book leaf' neoplasm [ventral surface of tongue and floor of mouth] (C06.89)
Does C14.8 affect Medicare Advantage HCC risk adjustment? +
Yes. C14.8 maps to CMS-HCC v28 category 11. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with C14.8? +
Procedures frequently paired with C14.8 include: 97130, 92608, 97129, 92607, 96110.
What ICD-9 codes does C14.8 map to? +
Per CMS GEMs, C14.8 maps to ICD-9 codes: 1498, 1499. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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